| Absolute Mental Health Clinic Llc | |
|
1303 Florida Ave Woodbridge VA 22191-3620 | |
| (571) 398-2758 | |
| Not Available |
| Full Name | Absolute Mental Health Clinic Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1303 Florida Ave, Woodbridge, Virginia |
| Authorized Official Name and Position | Maximo De La Cruz (CHIEF DIRECTOR) |
| Authorized Official Contact | 5715720050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Absolute Mental Health Clinic Llc 1930 Opitz Blvd Woodbridge VA 22191-3304 Ph: (571) 398-2758 | Absolute Mental Health Clinic Llc 1303 Florida Ave Woodbridge VA 22191-3620 Ph: (571) 398-2758 |
| NPI Number | 1366007460 |
|---|---|
| Provider Enumeration Date | 05/03/2019 |
| Last Update Date | 06/16/2022 |
| Certification Date | 06/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366007460 | NPI | - | NPPES |
| 201509030074274 | Other | VA | CERTIFICATE OF ASSUMED OR FICTITIOUS NAME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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